Effects of denosumab on bone mineral density and bone metabolism in patients with end-stage renal disease: A systematic review and meta-analysis

IF 1.2 4区医学 Q3 UROLOGY & NEPHROLOGY

Hemodialysis International Pub Date : 2023-06-01 DOI:10.1111/hdi.13098

Zhaoyan Gu, Xuhui Yang, Yan Wang, Jianjun Gao

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引用次数: 1

Abstract

Introduction

The effects of denosumab on bone mineral density (BMD) and metabolism in patients with end-stage renal disease (ESRD) remain controversial. Hence, we performed a systematic review and meta-analysis of observational studies.

Methods

The MEDLINE, EMBASE, and Cochrane Library databases were searched in June 2022 to identify studies that evaluated the risk of denosumab-associated hypocalcemia and changes in bone metabolism, changes in BMD from baseline to post-treatment in patients with ESRD.

Findings

Twelve studies with 348 participants were included. The pooled incidence of hypocalcemia during denosumab treatment was 35.0% (95% confidence interval [CI], 25%–46%; I² = 63.6%). There were no significant changes in either the serum calcium or phosphate levels from the baseline to post-treatment period; the mean differences were 0.04 mg/dL (95% CI, −0.12 to 0.20 mg/dL) and −0.39 mg/dL (95% CI, −0.89 to 0.12 mg/dL). We found significant changes in the alkaline phosphatase and parathyroid hormone levels; the standardized mean differences were −2.98 (95% CI, −5.36 to –0.59) and −3.12 (95% CI: –4.94 to –1.29), respectively. Denosumab may increase BMD, with mean differences of 9.10% (95% CI: 4.07%–14.13%) and 9.00% (95% CI: 5.93%–12.07%) for the femoral neck and lumbar spine, respectively.

Discussion

Denosumab increased the BMDs of the lumbar spine and femoral neck in patients with ESRD. The onset of hypocalcemia must be carefully monitored during denosumab administration.

查看原文本刊更多论文

狄诺沙单抗对终末期肾病患者骨密度和骨代谢的影响：一项系统综述和荟萃分析。

引言：狄诺沙单抗对终末期肾病（ESRD）患者骨密度（BMD）和代谢的影响仍然存在争议。因此，我们对观察性研究进行了系统回顾和荟萃分析。方法：2022年6月，检索MEDLINE、EMBASE和Cochrane Library数据库，以确定评估终末期肾病患者患狄诺沙单抗相关低钙血症的风险、骨代谢变化、骨密度从基线到治疗后变化的研究。结果：纳入了12项研究，共有348名参与者。狄诺沙单抗治疗期间的低钙血症合并发生率为35.0%（95%置信区间[CI]，25%-46%；I2 = 63.6%）。从基线到治疗后，血清钙或磷酸盐水平没有显著变化；平均差异为0.04 mg/dL（95%置信区间，-0.12至0.20 mg/dL）和-0.39 mg/dL（95%置信区间，-0.89至0.12 mg/dL）。我们发现碱性磷酸酶和甲状旁腺激素水平发生了显著变化；标准化平均差异分别为-2.98（95%CI，-5.36至-0.59）和-3.12（95%CI：-4.94至-1.29）。Denosumab可增加骨密度，股骨颈和腰椎的平均差异分别为9.10%（95%CI:4.07%-14.13%）和9.00%（95%CI:5.93%-12.07%）。讨论：Denosumab增加ESRD患者腰椎和股骨颈的BMD。在给药期间，必须仔细监测低钙血症的发作。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Hemodialysis International UROLOGY & NEPHROLOGY-

CiteScore

2.50

自引率

0.00%

发文量

审稿时长

6-12 weeks

期刊介绍： Hemodialysis International was originally an annual publication containing the Proceedings of the International Symposium on Hemodialysis held in conjunction with the Annual Dialysis Conference. Since 2003, Hemodialysis International is published quarterly and contains original papers on clinical and experimental topics related to dialysis in addition to the Annual Dialysis Conference supplement. This journal is a must-have for nephrologists, nurses, and technicians worldwide. Quarterly issues of Hemodialysis International are included with your membership to the International Society for Hemodialysis. The journal contains original articles, review articles, and commentary to keep readers completely updated in the field of hemodialysis. Edited by international and multidisciplinary experts, Hemodialysis International disseminates critical information in the field.